Provider Demographics
NPI:1699163030
Name:MCALEXANDER, JAYNE (MA, MSW, LCSW, DMIN)
Entity type:Individual
Prefix:
First Name:JAYNE
Middle Name:
Last Name:MCALEXANDER
Suffix:
Gender:F
Credentials:MA, MSW, LCSW, DMIN
Other - Prefix:
Other - First Name:CHARLENA
Other - Middle Name:JAYNE
Other - Last Name:MCALEXANDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1025 S 6TH ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62703-2403
Mailing Address - Country:US
Mailing Address - Phone:217-528-7541
Mailing Address - Fax:
Practice Address - Street 1:1025 S 6TH ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62703
Practice Address - Country:US
Practice Address - Phone:217-528-7541
Practice Address - Fax:217-527-8195
Is Sole Proprietor?:No
Enumeration Date:2015-01-08
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9891741041C0700X
IL1490200631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical